Changes in Frailty Predict Changes in Cognition in Older Men: The Honolulu-Asia Aging Study.
Changes in Frailty Predict Changes in Cognition in Older Men: The Honolulu-Asia Aging Study.
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DOI：
10.3233/jad-151172
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发表时间：
2016-06-15
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影响因子：
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通讯作者：
Andrew MK
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作者：
Armstrong JJ;Godin J;Launer LJ;White LR;Mitnitski A;Rockwood K;Andrew MK
由于认知能力下降主要发生在晚年，通常与许多其他疾病共存，因此在理解认知变化时考虑脆弱性是很重要的。在这里，我们研究了一个经过充分研究的老年日裔美国男性队列中虚弱状态变化与认知轨迹的关联。采用前瞻性檀香山-亚洲老龄化研究（哈斯），对2817名日裔男性进行了随访（基线年龄为71-93岁）。从1991年开始，每两到三年进行一次后续健康评估，使用认知能力筛查工具（CASI）测量认知能力。在这项研究中，健康数据被用来构建一个赤字脆弱指数（FI）的积累。使用6波数据，构建多水平生长曲线分析，以检查与虚弱指数（FI）变化相关的认知同步变化，控制基线虚弱，年龄，教育和APOE-ε4状态。平均而言，CASI评分每年下降2.0分（95%置信区间1.9-2.1）。在6个波中，相对于基线，虚弱程度每增加10%，CASI评分就降低5.0分（95%置信区间4.7-5.2）。基线虚弱和年龄与较低的初始CASI评分相关，并且在五次随访评估中与较大的下降相关（p < 0.01）。老年人健康状况受损会对认知产生不利影响。使用多维度的虚弱测量，基线状态和虚弱的人内变化都可以预测认知轨迹。
As cognitive decline mostly occurs in late life, where typically it co-exists with many other ailments, it is important to consider frailty in understanding cognitive change. Here, we examined the association of change in frailty status with cognitive trajectories in a well-studied cohort of older Japanese-American men. Using the prospective Honolulu-Asia Aging Study (HAAS), 2817 men of Japanese descent were followed (aged 71–93 at baseline). Starting in 1991 with follow-up health assessments every two to three years, cognition was measured using the Cognitive Abilities Screening Instrument (CASI). For this study, health data was used to construct an accumulation of deficits frailty index (FI). Using six waves of data, multilevel growth curve analyses were constructed to examine simultaneous changes in cognition in relation to changes in the frailty index (FI), controlling for baseline frailty, age, education, and APOE-ε4 status. On average, CASI scores declined by 2.0 points per year (95% confidence interval 1.9–2.1). Across six waves, each 10% within-person increase in frailty from baseline was associated with a 5.0 point reduction in CASI scores (95% confidence interval 4.7–5.2). Baseline frailty and age were associated both with lower initial CASI scores and with greater decline across the five follow-up assessments (p < 0.01). Cognition is adversely affected by impaired health status in old age. Using a multidimensional measure of frailty, both baseline status and within-person changes in frailty were predictive of cognitive trajectories.